Morris tribune., 1887-01-05
v ANTISEPTIC SURGERY.

NbCnlllan Magazine.
V ANTISEPTIC SURGERY.
A Wonderful Advance Over the Old Methods o.
Treating Wounds. .- -
From the Philadelphia North American.
Fifty years ago, on the minutes o.
the Pennsylvania Hospital in this
city, especial mention was made Of
the fact that an amputated finger had
healed by "tirst Intention" that is,
without the process OF suppuration
and granulatiCn; which IS the, usual
mode by which tissues heal At the
present time it is usual and not TN.
usual, to have an amputated leg heal
by the "frst intention" as we'll as the
wounds made in the performance oi
nearly all major and minor opera,
tions OF surgery.
So rapid has been the progress in
the improved methods of what is
known as antiseptic surgery. that
many medical men are astounded to
hear of the results that are being
obtained, and the general public are
not at all aware of the great advances
in the surgical art. Indeed, antiseptic
surgery has been in it's infancy for less
than a dozen years, and has only re.
ceived its perfect application within a
! few months.
In the human body there exists d
reparative power by which the sepa-
rated fragments of broken bone are
united The simplest mode of heal
ing an open wound is by the FIRST in
tention" or immediate union" for
which surgeons have aimed Tor hun
dreds OF years. They had observed it
in rare instances, and looked upon it
as a possibility, but as previously
stated, they seldom succeeded in get
| ting it, and the instances in which
| they did get it were deserving OF
| special note. If union fails by the
''frst Intention inflammation super
venes, and healing is accomplished by
a long and tedious process of suppu-
ration and granulation, requiring sew
eral weeks or perhaps months for the
closure of wound of any cOnsidera-
ble size. And this is always connected
with q great drain on the vital forces,
and danger from blood-poisoning.
What is antiseptic surgery? 1t con-
sists of certain precautions and ap-
pliances for the exclusion of the air,
and with the air the numerous germs
OF disease and putrefation which float
in it, and the application of q germi-
eide, which destroys the vitality OF
these germs during and after an op-
Grafton. The more perfectly this is
done, the more likely will there be
procured the primary union by "first
Intention" Everybody knows that a
cut OF finger, if promptly tied up and
kept at rest, Will heal readily, but if it
be neglected and allowed to get par
ticles of dirt and the germs of disease
into it, there is considerable inf1am-
nation, the injured member becomes
painful and swollen, discharges mat
ter and is slow to heal. Antiseptic
surgery aims at the simplicity of"do-
mesctic practice-the accurate coapta-
tiOn OF the parts, provision being
made for the free discharge of secre-
tiOns from the wound, and the exclu-
sion OF the air and germs OF disease.
By the adoption of antiseptic meas
ures the surgeon simply follows
natures indication. He puts the
parts in the best possible condition
to heal, and nature does the healing
The methods adopted IN order to
secure this success are simple, and
but little more expensive, consider
ing the first cost, but infinitely less
costly than the old way OF dressing,
when constellation is made for the
time and waste OF repeated dressings,
and the iessened risk of blood-poison-
ing and death f:om exhaustion from
prolonged suppuration.
The most essential element in anti
septic surgery is cleanliness. The
part to be operated upon, or the
point Of injury adjacent tissue, is first
thoroughly scrubbed with soap and a
fine brush 1t is then shaved to re-
move hair and dead cutaneous cells,
and afterwards washed with ether,
to remove fat and oily matter. 1t is
then washed with an antiseptic solu-
tion, and the operation is begun. A
small stream OF the solution is played
upon the part at short, intervals as
the operation progresses. Every
opening in the tissues Is washed out
with this solution. The parts are
brought together with catgut, sutures,
which have been rendered aseptic, and
these sutures are absorbed, conse-
quently there is nothing to come
away. Catgut being an animal
tissue, is capable of absorption,
and is used for ligaturing ves-
sells, sewing up the parts and for
drainage. For this purpose several
strands are placed in the deeper part
of q wound and drain by capilarity.
After there is no further secretions
these are absorbed. After the super
fetal opening has been closed=and the
edges brought into close opposition,
strip of protective" is laid over
the line of sutures. Over this is
spread fold of several thicknesses of
gauze, antiseptically prepared and
busted thickly on it's surface with
lodoform. Over this is placed cotton,
also rendered antiseptic, and the
whole dressing is confined in place by
roller bandages. This dressing is put on
wet-all wet ana almost dripping with
the antiseptic solution. The dressing is
not changed unless there is some sign
that all is not doing well, until @
proper time has elapsed and it is
known that the parts have healed.
Under these methods hospital gan
creme and erysipelas are veryrarely en-
countered, and there is so little dis
charge of pus that recently it was inn
possible to get enough for exhibition
to class at q medical college.
This method, with slight changes in
the detail, is now employed at every
good hospital in the country, and by
every surgeon who is up with the
times.
How rapid has been the change from
pine knots to tallow dips, from tallow
dips to whale oil, from whale oil to